Delaware public health officials report investigating an outbreak of pertussis, commonly known as whooping cough, in Kent County.

Image/National Atlas of the United States
Image/National Atlas of the United States

The outbreak investigation began in June when the Division of Public Health (DPH) learned of cases occurring among the county’s Amish population. Pertussis is a reportable disease in Delaware, and notification to DPH of confirmed or suspected cases is required.

As of August 18, 2018, DPH had identified 97 cases of the disease among Amish individuals. On August 22, DPH received confirmation that the disease has spread, infecting a Kent County child, whose family has ties to the Amish, but lives outside of the community.

“This is an extremely serious situation. Whooping cough is a highly communicable disease, and infants and young children are at greatest risk for severe, even deadly, complications,” said DPH Director Dr. Karyl Rattay. “Pertussis is a vaccine-preventable disease and we are urging everyone to make sure they are up to date on their immunizations. It is the best and most proactive preventive measure you can take.”

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DPH has been working with members of the Amish community to control the spread of the disease by having discussions with Amish leaders, sharing prevention and social distancing tips directly with infected individuals, and distributing flyers with the tips throughout the community. The last outbreak of pertussis in Delaware occurred in early 2014, also among Kent County’s Amish population. More than 200 people were affected.

Whooping cough is a highly contagious disease transmitted by coughing or sneezing, or coming in direct contact with respiratory secretions of infected persons. The most common symptom is uncontrollable coughing spells often followed by a characteristic “whoop” sound. The disease can cause severe illness in infants and young children.

Vaccination is the best defense against whooping cough, as well as many other diseases such as influenza, measles and mumps. For children to be fully immunized against whooping cough, they need five doses of the vaccine (at ages 2, 4 and 6 months, between 15 and 18 months, and between 4 and 6 years). Women should also be vaccinated with every pregnancy in order for the infant to have some immunity upon birth. Adults who will have regular contact with children, or parents of a newborn and younger children, should also get vaccinated. Pertussis may occur among persons of any age, including teens and adults who were vaccinated only at a young age, although infants less than 1 year of age have the highest rates of complications. Whooping cough often makes babies and young children so sick that they need to be hospitalized. Older children, adults, vaccinated individuals and those who have had whooping cough in the past may experience a milder illness, but can still spread the disease to younger members of the community, some of whom may be too young to be fully vaccinated. An infected person can spread the disease starting when symptoms begin to three weeks after the onset of coughing. Coughing frequently lasts for several weeks.

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Pertussis is treated with antibiotics. During treatment, individuals who have the disease should stay home and distance themselves from well people in the home as much as possible, cough or sneeze into the inner elbow if tissues aren’t immediately available, and wash hands frequently. After completing a five-day course of antibiotic treatment, the individual can return to work, school or other community activities.